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General NPI Number Information
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NPI Number | 1518456375
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Entity Type | Organization
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Legal Business Name | RYAN M. OWASKI, D.D.S., P.A.
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 11382 PROSPERITY FARMS RD STE 129
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3463
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Country | US
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Telephone | 561-622-9601
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Fax |
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Provider Business Mailing Address
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Address Line | 11382 PROSPERITY FARMS RD STE 129
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3463
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Country | US
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Telephone | 561-622-9601
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN MICHAEL OWASKI
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Credential | DDS
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Telephone | 917-445-7835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN18578
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License Number State | FL
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